Shin Splint

 

You may have experienced pain in the front of the leg after a long period of exercise or a busy day of constant walking and running. Shin splints are pain in the front and inside of the leg (especially in people who run a lot). A problem also known as 'medial tibia stress syndrome'. What you will read next:

 

Introduction to leg anatomy

Leg muscles

What causes shin splints?

Who is at risk for shin splints?

Specifications and symptoms of shin splint pain

What are the different diagnoses of shin splints?

Shin splint treatment

Types of shin splints

When can we return to exercise after shin splint treatment?

What can we do to prevent recurrence of shin splints?

 

Introduction to leg anatomy:

The human tibia consists of two bones, a Tibia or Shin bone that is located inside the leg, which as the name implies is a large bone. This bone is the largest bone in humans after the femur. The second bone is located on the outside of the leg and called Fibula.

Leg muscles:

Many muscles are attached to these two bones from the front and the back, enabling movements in the ankles and toes as they contract. One of these muscles that connect to the front surface of the tibia, is called the anterior tibialis muscle. The tendon of this muscle attaches to the top of foot arce (dorsal surface). The posterior tibialis muscle is attached to the back surface of tibia, and its tendon attaches to the interior surface of foot arce where touchs the ground (palmar surface).

shin splint

What causes shin splints?

In short, shin splints are the result of excessive and repetitive movements of the bones and muscles of the calf. In fact, following repetitive movements, the tendons, membranes that cover  the bones (periosteum) and the muscles around the tibia, or shin bone, become inflamed, causing pain at the inner edge of the shin bone, where the muscles are attached to the bone.  

 

Who is at risk for shin splints?

  • Athletes who have started a new training program.
  • People who exercise hard and on ramp.
  • Sudden change in speed and direction of running
  • Increased exercise hours or exercise days
  • People with flat feet (flat feet increases pressure on the calf muscles during exercise)
  • Exercise or walk with non-standard shoes
  • Runners and jumpers
  • Professional dancers
  • Soldiers and military personnel

 

What are the main symptoms of people with shin splints?

The most common symptom in patients suffering from shin splints is pain that is felt along the edge (border) and in front of the tibia.

Specifications of shin splint pain:

  • Sharp pain similar to the pain felt when shaving hair
  • Stabbing or dull pain
  • Pain that occurs during exercise or after exercise
  • Pain that is felt in the morning after waking up
  • Pain is felt in the area that is three to fifteen centimeters higher than the inner ankle
  • The area is sometimes painful when touched
  • Occasionally there is a slight swelling in the inside and front of the leg

What are the different diagnoses of shin splints?

When you see a doctor for evaluation and treatment of shin splint pain, your doctor, in addition to a thorough examination, carefully examines other possible causes of leg pain, including the following:

Stress Fractures:

These are very delicate fractures that occur in the tibia due to overuse and repetitive activity.

Inflammation of the tendons (tendonitis):

The tendons attach our muscles to the bones. Excessive movement of the bones can cause inflammation of the tendons or tendinitis. There are also sometimes very small tears in the tendons of active muscles that may cause pain similar to leg pain.

Exertional compartment syndrome:

Occasional contractions and movements of the calf muscles increase the pressure in the calf compartments, which usually reduces the pressure and pain by stopping the exercise.

Sometimes X-rays may be needed to rule out other causes. Keep in mind that if your shin splint pain is not reduced by routine treatments, you may have one of the above diagnoses. 

Shin splint treatment:

Treatments fall into two general categories:

  • Non-surgical Shin Splint treatments: 

    • reduce or stop any exercises that cause pain.

    • Use of non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen

    • Cold therapy: you can pour some ice into a nylon bag and wrap a towel or a thin cloth around the nylon and place this pack on the sore spot several times a day for twenty minutes. Avoid direct contact of the ice with your skin.

    • Use of elastic compression bandages: standard bandages can prevent further swelling.

    • Flexible exercises: stretching the muscles in the front and bottom of the leg can relieve the pain of the splint to some extent.

    • Use appropriate and standard shoes or standard shoe insole: People with flat feet or people who have frequent shin splints can benefit from putting a standard insole inside their shoes. These insoles actually help keep your feet and heels in alignment and prevent lower part of the leg from excessive stress.

  • Surgical splint treatments:

    • Most patients with shin splint pain are cured by non-surgical methods, and only a very small number of patients require surgical procedures. 

Types of shin splints:

  • Anterior shin splint, seen in people who:

    • Are runners
    • Start moving After a period of time  
    • Start running at once
    • Qalk a long distance on their toes
    • Wear inappropriate shoes when running
    • Exercise a lot
  • Posterior shin splint:

    • It happens when there is no balance between leg muscles and calf musclesPeople who have flat (inflexible) soles or those whose calf muscles are stiff are more likely to have this pain.

When people with flat feet put their feet on the ground, the posterior tibialis muscle behind the leg and the tendon that connects to the sole of the foot stretches, causing inflammation and pain specially in repeated movement.

 

When can we return to exercise after shin splint treatment?

You should spend at least two weeks without pain. Only then you can start exercising lightly with complete caution.  

What can we do to prevent recurrence of shin splints?

  • Be sure to warm up well and do stretching exercises before a race or strenuous exercise, and do not do exercise and activity without preparation.
  • Increasing the intensity and speed of the exercises, or changing the type of exercise should be done step by step and gradually.
  • Do not exercise without standard shoes.
  • You can also use side sports such as cycling and swimming for better physical fitness.
  • As soon as you feel pain, stop the activity and apply a cold bag of ice on that area.

 

 

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